What is the clinical evidence from this study?

Study design: Observational. Population: Opioid use disorder (OUD) (n=186). Intervention: HPV self-collect screening. Primary outcome: Rates of screening uptake, HPV positivity, and successful linkage to follow-up care.

What question did this study set out to answer?

This evaluation aims to assess the feasibility and outcomes of HPV self-collection for cervical cancer screening within an opioid treatment program.

April 5, 2026

Abstract 2371: Outcomes after introduction of cervical cancer screening in an opioid treatment program (OTP) by offering HPV self-collect testing to an under-screened population

Key Result

HPV self-collect screening in an opioid treatment program achieved an 89.3% uptake among eligible patients, identifying a 20% high-risk HPV positivity rate.

Key Points

This evaluation aims to assess the feasibility and outcomes of HPV self-collection for cervical cancer screening within an opioid treatment program.
Implemented HPV self-collect screening in a traditional OTP and mobile units.
Eligible participants were those aged 25 and older who were overdue for screening or unsure of their status.
Collected samples privately in clinic restrooms and analyzed for hrHPV types.
Facilitated referrals and tracked follow-up for hrHPV positive patients.
Out of 168 eligible participants, 150 completed screening, indicating a high uptake rate.
Identified hrHPV positivity rates among participants were 4.7% for HPV16/18 and 15.3% for other high-risk types.
No patients were lost to follow-up, with 40% completing the necessary follow-up care.

Study Design

Type

Observational (n=186)

Multicenter

Yes

Structured PICO

Does offering HPV self-collect testing improve cervical cancer screening uptake and linkage to care in individuals with opioid use disorder?

Population

186 patients evaluated (168 eligible for screening, median age 40 years) in an opioid treatment program (OTP) in Washington state, who were overdue for cervical cancer screening or unsure.

Intervention

HPV self-collect screening offered during annual medical update visits.

Outcome

Rates of screening uptake, HPV positivity, and successful linkage to follow-up care

Integrating HPV self-collection into opioid treatment programs is a feasible and highly effective strategy to increase cervical cancer screening in an under-screened, high-risk population.

Abstract

Abstract Individuals with opioid use disorder (OUD) have lower cancer screening rates. Cervical cancers are preventable through screening and treatment of human papillomavirus (HPV)-related pre-cancers. HPV self-collect tests provide opportunities to expand screening access to previously unreached populations, offering advantages of privacy, autonomy, and negating a clinic requirement for gynecological services. We evaluated a novel, low-barrier model for integrating HPV self-collect screening into a brick-and-mortar OTP and its four associated mobile medication units in a major metropolitan area in Washington state. Screening was offered with self-collection kits during annual medical update visits to eligible patients (those age 25 or above with a cervix who were overdue for screening or unsure) and collected privately in the clinic restroom. HPV swabs were analyzed at the University of Washington HPV Molecular Pathology Laboratory or Labcorp and included all 14 known high-risk HPV (hrHPV) types. Screened subjects with positive results received education and recommendations for guideline concordant care. Clinic staff facilitated referrals to local providers with gynecologic services and follow-up was tracked. The study's primary outcomes were the rates of screening uptake, HPV positivity, and successful linkage to follow-up care. From June 24, 2024 through October 31st, 2025, 186 patients were evaluated including 29 (15.6%) American Indian/Alaskan Native, 2 (1.1%) Asian, 20 (10.8%) Black, 2 (1.1%) Native Hawaiian/Pacific Islander, 125 White (67.2%) and 9 (4.8%) Hispanic. The majority were current (72.9%) or former (17.6%) tobacco users. Of 168 (90.1%) eligible for screening (median age 40 years, range 22-65 years), 150 (89.3% of those eligible) completed screening. There were no failed or inconclusive test results. Of 150 resulted tests, 120 (80%) were HPV-negative, 7 (4.7%) were HPV16/18+, and 23 (15.3%) were “other” (non-16/18) hrHPV+. Patients encountered a variety of structural and social barriers in following up hrHPV+ tests. Of the 30 hrHPV+ tests, no one has been lost to follow-up and 12 (40%) patients have completed follow-up, which often required multiple coordination attempts by providers. The remainder are in various stages of referral and scheduling. Providing cervical cancer screening was feasible in an OTP using HPV self-collection and resulted in high patient uptake. This population was both under-screened and high-risk with approximately double the hrHPV positivity rate found in most U.S. screening studies. Our patient-centered model promotes health equity and provides a scalable solution to reduce the burden of cervical cancer in under-screened communities. Citation Format: Elizabeth M. Swisher, Mallory Davis, Mayumi Rubin-Saika, Enna Manhardt, Emiko Oshima, Renata Urban, Stephem L. Cherne, Eric Huang, Tom Hutch. Outcomes after introduction of cervical cancer screening in an opioid treatment program (OTP) by offering HPV self-collect testing to an under-screened population abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2371.

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